Electronic Medical Records May Not Be What They Are Cracked Up To Be

July 1, 2011- Sometimes it takes a while for the truth to sink in. In this case, the truth is: electronic medical records may not be what they are cracked up to be. Many doctors in small practices feel:

• EHRs often cost more than they are worth.

• They slow up practice.

• They may not prevent errors.

• They dehumanize practice by getting between the doctor and the patient.

It is, of course, impolitic to question the value of EHRs. If you do so, you are considered a Luddite, a reactionary stuck in the muck. But some of us continue our wayward ways anyway, as I do repeatedly in my book The Health Reform Maze (Greenbranch Publishing), due out later this summer.

Small practices have joined the chorus. As a June 30 Kaiser Health News piece, points out: only 7% of one or two person practices have installed EHRs. The voices of dissenting small practices is beginning to be heard.


Small Doc Groups Question Advantages of Health IT

By Bara Vaida

The government is offering as much as $27 billion in incentives to doctors and hospitals to adopt electronic health records, but the question is whether those incentives will be enough.

A new study published by the Center for Studying Health System Change and the National Institute for Health Care Reform illustrates the difficulty of getting everyone in the health care system to adopt electronic records.

The two organizations found that some physician practices with 25 or fewer doctors who were early adapters of electronic health records are unsure that their investment of time and money has been worth it.

“Despite the widely held belief that HIT adoption ultimately will save costs and improve quality, several respondents suggested the business case – adequate financial incentives and return on investment – remains somewhat unclear, especially in the short term,” said the report.

The study focused on five independent practice associations (IPAs) that had purchased health information technology systems to enable a range of functions from sending prescriptions to pharmacies electronically to accessing local laboratory and hospital clinical information. IPAs are legal entities that represent groups of independent physicians who have agreed to share in support costs. To gather information for the survey, the institute telephoned 27 people involved in the IPAs between March and May 2010.

Among the problems the early adapters cited were technical difficulties and lack of training offered by health IT providers, lost productivity while staff learned to use the electronic systems, and the inability to get systems to talk to other electronic health systems.

Nationally, only 7 percent of doctors with one or two physicians have adopted electronic health systems. Since more than half of doctors practice in groups of five or fewer doctors, physicians have a long way to go in joining the age of health IT.

Despite the challenges listed in the study, the Center for Studying Health System Change and the National Institute for Health Care Reform said the challenges faced by these early adapters could serve as lessons learned to help small physician groups, who likely will have to buy health IT systems if they want to treat Medicare patients in the future. As part of the health law, doctors treating Medicare patients will face a penalty if they aren’t using electronic records by 2015.

bvaida@kff.org